RESUMO
Von Hippel-Lindau (VHL) disease along with chronic thromboembolic pulmonary hypertension (CTEPH) is a unique and unusual severe complication of ventriculoatrial (VA) shunt implantation in the treatment of hydrocephalus. To the best of our knowledge, this can be the first reported case of an effective treatment with balloon pulmonary angioplasty in a patient with VHL after VA shunt placement. The patient underwent six balloon pulmonary angioplasty procedures. All invasive procedures resulted in haemodynamic and functional improvement.
Assuntos
Angioplastia com Balão , Hidrocefalia , Hipertensão Pulmonar , Embolia Pulmonar , Doença de von Hippel-Lindau , Doença Crônica , Humanos , Hidrocefalia/etiologia , Hidrocefalia/cirurgia , Hipertensão Pulmonar/terapia , Embolia Pulmonar/complicações , Doença de von Hippel-Lindau/complicaçõesRESUMO
A case of a 48 year old female admitted to the hospital for further evaluation and treatment of an intracardiac tumour, is presented. The patient underwent surgical excision of the tumour localised in the right ventricular outflow tract with bioprosthetic tricuspid valve implantation and pacemaker insertion due to the procedure-related compete atrio-ventricular block. Histopathological examination revealed the presence of thyroid tissue in the excised tumour. Data published in literature dealing with this topic are reviewed.
Assuntos
Coristoma , Cardiopatias/patologia , Glândula Tireoide , Feminino , Cardiopatias/diagnóstico por imagem , Cardiopatias/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
There is a wide interpersonal difference to dobutamine response during dobutamine stress echocardiography (DSE). The aim of this study was to determine an association between GNB3 825C>T gene polymorphism, encoding the ß3-subunit of G protein, and heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP) response to dobutamine during DSE. The study involved 119 patients with clinical indications for DSE. Genotyping of GNB3 825C>T (rs5443) polymorphism was based on PCR-RFLP method with BseDI restriction enzyme. Significantly higher levels of both resting SBP and DBP in 825T allele carriers vs. 825CC patients were revealed. HR of 825CC vs. CT + TT subjects was slower along the test period reaching marked difference at dobutamine level 30 µg/kg/min (109 ± 20 vs. 116 ± 18 bpm, respectively, p = 0.047). SBP and DBP were markedly lower in 825CC homozygotes compared to 825T allele carriers throughout DSE. It can be concluded that GNB3 825C>T polymorphism is associated with resting SBP and DBP in Polish Caucasian patients subjected for diagnostic DSE. The polymorphism also modulate HR, SBP and DBP response during DSE.
Assuntos
Hemodinâmica/genética , Proteínas Heterotriméricas de Ligação ao GTP/genética , Alelos , Pressão Sanguínea/genética , Diástole/genética , Dobutamina , Ecocardiografia sob Estresse/métodos , Ecoencefalografia/métodos , Feminino , Frequência Cardíaca/genética , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Sístole/genéticaRESUMO
We present a case of Gerbode type defect (left ventricular to right atrial communication) discovered in a 52 year-old man with atrial and ventricular septal defects. The patient was diagnosed using two-dimensional colour Doppler and transoesophageal echocardiography. We describe the echocardiographic features and review the anatomical consequences of such defects. Our aim was to remind readers about this rare organic heart disease that an inexperienced echocardiography specialist might easily mistake for a recoil wave of tricuspid valve incompetence and thus diagnose pulmonary hypertension.